This is Steven Salzberg's blog on genomics, pseudoscience, medical breakthroughs, higher education, and other topics, including skepticism about unscientific medical practices. Here's where I can say what I really think about abuses and distortions of science, wherever I see them.

Here's the thing: eating is easy, and fasting is hard. If you're going to fast to lose weight, you probably will lose a bit, but the evidence is that most people gain the weight back fairly soon once the fasting diet is over. So fasting might provide a quick reward in terms of weight loss, but the loss will be fleeting.

Suprisingly, though, fasting may be a good idea. A recent review by Stephen Anton and colleagues, in the journal Obesity, found that intermittent fasting may come with a variety of health benefits, including reducing inflammation, improving the ratio of lean tissue to fat, improving cognitive function, preventing type 2 diabetes, and possibly even prolonging life span.

How does fasting produce these benefits? Professor Valter Longo of USC, one of the leading researchers on fasting and longevity, hypothesizes that fasting forces your body to recycle many of its immune cells, particularly white blood cells. Then your body works hard to replenish its white blood cells, essentially re-setting parts of your immune system. Longo is also the inventor of the fast-mimicking diet, where you eat a special diet for 5 days every month, one that makes your body think you're fasting even though you're getting adequate calories and nutrients. (See Alice Walton's story in Forbes for more about that.)

Another effect of fasting is a change in metabolism. As Anton's article explained:

"the key mechanism responsible for many of these beneficial effects appears to be flipping the metabolic switch."

This happens when the body runs out of its normal fuel, glucose, and begins to burn fat, which means it's converting fat to fatty acids, which in turn produce ketones. The body then uses ketones instead of glucose.

So how much fasting do you need to flip the switch from glucose to ketones? Anton et al. write that

"The metabolic switch usually occurs between 12 and 36 hours after cessation of food consumption, depending on the liver glycogen content and on the amount of exercise during the fast."

This doesn't tell the whole story, because once the switch occurs, you need to burn ketones for some time to gain any benefits. Back in 2014, I wrote about new evidence (from Valter Longo's research) that a longer fast, such as 3 days or more provide significant long-term health benefits. Three days is a long time to fast, but Longo has said that you don't need to do it more than a few times per year.

If you do decide to try a fast, don't expect it to be easy: you're going to get really hungry, and fasting can also interfere with social obligations in an inconvenient way.

I should emphasize that the evidence isn't yet clear for any of these strategies, and there are multiple studies going on now that may provide a clearer picture. Nonetheless, despite the current fad of fasting strategies and diets, fasting really does seem to have some potential health benefits.

(A final caveat: fasting can be harmful, especially for people who have other health problems. If you’re seriously thinking of trying this, you should consult your doctor first.)